Blue Cross Blue Shield FEP Dental
Summary of Benefits
Summary of Benefits
Summary of Benefits
- Do not rely on this chart alone. This page summarizes your portion of the expenses we cover; please review the individual sections of this brochure for more detail.
- If you want to enroll or change your enrollment in this plan, please visit www.BENEFEDS.com or call 1-877-888-FEDS (3337), TTY number 1-877-889-5680.
- Out-of-network services under Class A, B and C are subject to a $50 deductible per person under High Option and a deductible of $75 for Standard Option per person per calendar year.
- For children age 13 and under, you pay $0 for in-network Class B and Class C covered services as defined by the plan, subject to plan maximums.